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IMF-046-02-0001-en	Why can a record that contains every historical fact still fail the next clinician?	If it does not show what is dangerous now, what changed, what is uncertain, what response is expected and who owns the next action, the current state cannot be reconstructed.	Integrated Medical Foundations; chapter 46, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 25b62526f357b88a34c756f1596fe1c2ae7ec00fa75e16391089c9b4c183bbfd; editorial review pending	imf lang::en chapter::046 module::046-02 review::pending
IMF-046-02-0002-en	Why should a new rash or absent response to antibiotics force revision of the problem representation?	The representation is provisional; such findings should reshape it rather than being appended to an unchanged label.	Integrated Medical Foundations; chapter 46, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 25b62526f357b88a34c756f1596fe1c2ae7ec00fa75e16391089c9b4c183bbfd; editorial review pending	imf lang::en chapter::046 module::046-02 review::pending
IMF-046-02-0003-en	Using acute kidney injury as an example, how do causal links reduce duplication in a problem list?	Linking kidney injury to sepsis and nephrotoxins, and to its effects on antibiotic dose and fluid tolerance, shows causes and consequences together instead of as separate problems.	Integrated Medical Foundations; chapter 46, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 25b62526f357b88a34c756f1596fe1c2ae7ec00fa75e16391089c9b4c183bbfd; editorial review pending	imf lang::en chapter::046 module::046-02 review::pending
IMF-046-02-0004-en	Why might a diagnosis with no discordant data be less certain than it appears?	It may reflect inadequate testing rather than certainty; predicting what should happen next lets an unexpected trajectory act as evidence that prompts a diagnostic pause.	Integrated Medical Foundations; chapter 46, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 25b62526f357b88a34c756f1596fe1c2ae7ec00fa75e16391089c9b4c183bbfd; editorial review pending	imf lang::en chapter::046 module::046-02 review::pending
IMF-046-02-0005-en	Why are timing and specimen quality part of a test order?	Cultures taken after antibiotics, a superficial swab for deep infection, or a troponin without a time relation can answer a different question from the one intended.	Integrated Medical Foundations; chapter 46, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 25b62526f357b88a34c756f1596fe1c2ae7ec00fa75e16391089c9b4c183bbfd; editorial review pending	imf lang::en chapter::046 module::046-02 review::pending
IMF-046-02-0006-en	Why does repeating the same intervention without a response model turn treatment into ritual?	A trial is interpretable only with a defined target and timeframe; without them, insufficient delivery, wrong mechanism, irreversible disease or inadequate observation time cannot be considered.	Integrated Medical Foundations; chapter 46, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 25b62526f357b88a34c756f1596fe1c2ae7ec00fa75e16391089c9b4c183bbfd; editorial review pending	imf lang::en chapter::046 module::046-02 review::pending
IMF-046-02-0007-en	Why should an escalation call lead with urgency and the requested action?	A request buried in a long chronology is less safe; closed-loop communication then requires the receiver to acknowledge the message and clarify the plan.	Integrated Medical Foundations; chapter 46, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 25b62526f357b88a34c756f1596fe1c2ae7ec00fa75e16391089c9b4c183bbfd; editorial review pending	imf lang::en chapter::046 module::046-02 review::pending
IMF-046-02-0008-en	Why is a handover instruction simply to check potassium incomplete?	Handover transfers prospective responsibility, so the task needs why, when, owner, expected result and abnormal action: repeat at eight because replacement finished, and call if outside range.	Integrated Medical Foundations; chapter 46, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 25b62526f357b88a34c756f1596fe1c2ae7ec00fa75e16391089c9b4c183bbfd; editorial review pending	imf lang::en chapter::046 module::046-02 review::pending
IMF-046-02-0009-en	What must replace an instruction to restart a held medicine when the patient improves?	A specific condition, such as blood pressure, kidney function, cessation of bleeding, oral intake or days after a procedure, and a named responsible person.	Integrated Medical Foundations; chapter 46, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 25b62526f357b88a34c756f1596fe1c2ae7ec00fa75e16391089c9b4c183bbfd; editorial review pending	imf lang::en chapter::046 module::046-02 review::pending
IMF-046-02-0010-en	Why is documenting a patient as aggressive and noncompliant weaker than recording that the patient shouted and left the room?	The first is a judgement that loses context, while the second is an observation; documentation separates observation, reported history and inference.	Integrated Medical Foundations; chapter 46, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 25b62526f357b88a34c756f1596fe1c2ae7ec00fa75e16391089c9b4c183bbfd; editorial review pending	imf lang::en chapter::046 module::046-02 review::pending
IMF-046-02-0011-en	Why does a normal blood test not make discharge safe for a person who cannot climb their home stairs?	Discharge is safe when necessary care can be delivered at the destination, not when hospital tests are finished.	Integrated Medical Foundations; chapter 46, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 25b62526f357b88a34c756f1596fe1c2ae7ec00fa75e16391089c9b4c183bbfd; editorial review pending	imf lang::en chapter::046 module::046-02 review::pending
IMF-046-02-0012-en	Why is automated inbox delivery of a pending result not the same as ownership?	Ownership needs a named reviewer, expected availability, communication method and action threshold; delivery is not ownership if nobody is scheduled to check it.	Integrated Medical Foundations; chapter 46, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 25b62526f357b88a34c756f1596fe1c2ae7ec00fa75e16391089c9b4c183bbfd; editorial review pending	imf lang::en chapter::046 module::046-02 review::pending
IMF-046-02-0013-en	Why does longitudinal care need a coordinating generalist to integrate disease-specific plans?	The plans can conflict: tight pressure control can worsen falls, fluid restriction can impair nutrition, and anticoagulation reduces stroke while increasing bleeding, so someone must identify the outcomes that matter most.	Integrated Medical Foundations; chapter 46, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 25b62526f357b88a34c756f1596fe1c2ae7ec00fa75e16391089c9b4c183bbfd; editorial review pending	imf lang::en chapter::046 module::046-02 review::pending
IMF-046-02-0014-en	Why is an instruction to be more careful weak prevention after a near miss?	Stronger prevention is matched to the failure mechanism: standardisation, forcing functions, simpler processes, independent checks for high-risk steps and feedback on outcomes.	Integrated Medical Foundations; chapter 46, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 25b62526f357b88a34c756f1596fe1c2ae7ec00fa75e16391089c9b4c183bbfd; editorial review pending	imf lang::en chapter::046 module::046-02 review::pending